Canada is the most under-discussed thing on this board
Canada is the most under-discussed thing on this board — a position I have arrived at slowly and would like tested. Employer-sponsored plans have their own criteria and appeal processes, independent of the provincial formulary. Which one applies determines everything about the route. Read the special authorization…
The pharmacist sorted in five minutes what the phone line had not managed in a fortnight.
Left up. It distinguishes a rejected claim from a denied authorization, which most posts here do not.
compare cash prices before assuming coverage is the only path
keep every form, every date, every reference number
I would not read one pharmacy’s cash price as the going rate. The spread is real.
Compared cash prices across four pharmacies before pursuing coverage and the spread was larger than I expected.
Moved provinces and the coverage position changed completely. Same person, same history, different formulary.
That is an employer plan process, and the provincial route is different in both form and timeline.
Is there a quantity limit involved rather than a coverage refusal?